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Editor's note: A section of this article has been taken down because of a misunderstanding between the reporter and a source about what level of anonymity the source requested. We apologize for any pain caused. The Eye remains committed to fair and accurate reporting.

Phylicia Hisel was not supposed to leave. Yet, there came a day when she realized she could not stay.

She had the same plan as any one of us: Come to Columbia, graduate in four years. Make her family proud.

That plan sounded so good, so gratifying. Most importantly, it was what we consider normal. It was—and is—the picture of success, just one part of the culturally-sanctioned life trajectory: four years of high school, four years of college, maybe a grad degree, work, and retirement. To the average (intelligent, competitive) Columbia student, straying from that track sounds scary, not to mention humiliating. At best, taking time off seems unacceptable.

So, college was "supposed" to be a four-year deal, and Hisel was "supposed" to be happy and healthy the whole time. When she instead found herself needing a medical leave, she wasn't prepared. Not one among us bright, young Columbians ever thinks we'll find ourselves in a situation like Hisel's, after all.

As Hisel's roommate sophomore year, I was there to witness her struggle in slow motion. Our conversations about Columbia developed into questions of how one can be happy at this university and whether that was possible for her. A first-generation student who chose Columbia because it offered her the best financial aid package, she felt unprepared. She found the competitive and elitist atmosphere oppressive, and had difficulty relating to some of her prep-school-bred peers.

She soon found herself trapped in a vicious cycle. She would sit down and try to work, but couldn't even start. Fear of failure kept her paralyzed and unmotivated, further convincing her that she wasn't cut out for Columbia. Combined with a bad break-up, a harsh winter, and a mounting pile of missed deadlines, depression took hold.

Hisel knew it wouldn't be healthy to stick out the rest of the semester. She realized that a series of withdrawals from classes would look better than a series of Fs, but the decision to take medical leave was incredibly difficult for her to accept.

The hard part about taking time off, for Hisel, was not the paperwork or gaining administrative approval. It was admitting—to herself and to others—that she was straying from the track that she felt she was supposed to be on.

In an attempt to fight the stigma towards taking a leave of absence, she resolved that this "supposed" track is a myth. Life isn't supposed to be set on a one-way railroad. She decided that a good life should take a few bends—that's when people grow the most.

Unfortunately, not even her own redefinition of a good life could fully convince Hisel that there was no shame in taking leave. In many ways, the cultural impression was set—leave is for people who can't hack Columbia, and depression happens to people who can't hack life. Unfair and incorrect though that idea may be, it was ingrained deeply enough in Hisel's mind to keep her at Columbia even after realizing she needed to leave. Only weeks later, with what she felt was a great leap of faith, did she decide that a break might allow her to restore a healthy internal balance that she was sorely missing in school.

When It's Not Your Choice

Hisel requested and received what the University calls "medical leave of absence" or "medical withdrawal," and sometimes "medical leave." According to the University's website on "Essential Policies for the Columbia Community," this type of leave is granted to "a student whose health prevents them from successfully pursuing full-time study." Interestingly, this type of leave falls under "voluntary leave"—because while it is not something anyone wants to do, the student ultimately withdraws oneself, and the student is typically the one who initiates the leave process.

But that's where the similarities between "medical withdrawal" and any other type of "voluntary leave" end. Students requesting medical leave must have the physician or Counseling and Psychological Services practitioner who has been treating them confirm to the student's dean that a medical leave is necessary. Luckily, when and if medical withdrawal is granted, the student is guaranteed housing upon return. This is not true of any other voluntary leave. For readmittance, a student on medical leave must usually demonstrate that he or she has recovered from the condition that necessitated leave so as to allow resumption of studies. This means sending medical records from the period of leave to the University, and having an "assessment interview"—a physical and/or psychological examination at Columbia Health or CPS about one month prior to the prospective return. For Hisel, the process of taking medical leave was an emotional battle. Still, she is arguably one of the luckier ones—the decision was her own.

Sometimes a student doesn't get to make the decision; involuntary leave is something that can and does happen. The Dean of Students may place a student on involuntary leave for "reasons of personal or community safety." According to the University's website, this occurs only in "extraordinary circumstances"—when it is clear that a student's condition or behavior could cause serious harm to others or when there is serious risk that the student will harm him or herself, and the University does not have the resources or support to eliminate the risk. If the risk is significant enough, a student might be subject to "immediate removal" before the involuntary leave paperwork and proceedings are even complete.

Similar policies at other universities have recently come under fire. In November, a student at Brown University wrote an open letter to the Brown community about the death of a student, Michael Dawkins, implicating his forced leave as a cause of his suicide. A student at Yale University documented her first-person account of the school's forced leave policy, claiming that while her year off helped her get "closer to [her] ideal center," Yale's decision to forcibly remove her came across as an inappropriate punishment for being open about her problems.

One year ago at Columbia, Juilliard exchange student Oren Ungerleider sued the University for committing him to 30 days at St. Luke's Hospital against his will in 2010. Ungerleider feels that the hospitalization and the mandated year-and-a-half leave that followed were unjust, causing "mental anguish, emotional distress, public humiliation, and dangerous conditions."

Involuntary leave, though, is rare according to administrators, because it is more likely that a student will agree to take medical leave before being forced to do so by Columbia's administration.

The University isn't subtle in encouraging a struggling student to take leave; the "encouragement" will come not only from an advising dean, but also from counselors at CPS and medical staff if necessary. An example is Columbia's eating disorders team. "Required Medical Leave for Students with Eating Disorders" is its own policy outside of voluntary, medical, and involuntary leave. This is perhaps because eating disorders, depending on their gravity, require a very specific type of treatment that Columbia is not set up to offer.

A group of four practitioners—a nutritionist, a therapist, a nurse practitioner, and a physician—constitute the "Eating Disorder Team" on campus. If a student goes to see one of these four, they are often referred to see the others as well. Then, the four practitioners, with permission, can meet and discuss a student's case, and in some cases alert the DOS that they will be suggesting medical leave. All five can meet individually with the student and "encourage" leave. If a student still refuses, he or she is informed that involuntary leave is being considered. The student is also informed that involuntary leave is a much more complicated—and much less confidential—process than voluntary leave.

One anonymous Columbia student battling an eating disorder had the Eating Disorder Team tell her that she had to take a year off, and threatened involuntary leave if the student didn't agree. Though this student has since returned to Columbia after a year away—during which she successfully recovered from her eating disorder—she recalls the conversation with pain. "That made withdrawing myself feel like surrendering—one of the most painful memories," the student who wished to remain anonymous due to the sensitive nature of her situation remarks. Though it can be uncomfortable to have to admit you need to take time off, it's hurtful—even scarring—when it doesn't feel like it is your choice.

Some campus activist groups, notably the Student Wellness Project and Active Minds, are preparing to address issues with leave of absence at Columbia. Beyond addressing financial concerns for low-income students who take breaks, student activists have largely taken up the question of what students are to do if they need to take a leave of absence but claim that they are better off at school.

Barnard College senior Rakhi Agrawal has been looking into forced leave at Columbia, Barnard, and other universities. Though she has not taken a leave of absence, she fears that at the start of this semester—her senior spring, of all semesters—academic and psychological issues may force her to leave. Even if her advisor strongly encourages her to voluntarily accept medical leave, Agrawal firmly believes that taking a leave would be far worse for her than staying at Barnard, where she has her support network.

Requiring students to take leave can be damaging to those who don't have supportive home networks to return to, Agrawal says. "I think current policies both at Barnard and Columbia don't take into account a student's home situation, and the fact that for many students, there could be more resources and support at school than at home. If students don't have emotional or financial support at home, it can be more harmful for them to be away from their support network in college."

Even for students who do come from supportive homes and who are open to the idea of taking leave, being forced by the University to take leave can be far more emotionally draining than coming around to the decision on their own. Given the stigma around taking a leave, when the decision is out of a student's hands, it can feel like the University is punishing them—worse, kicking them out—for their struggles with mental health.

On the rare occasion that a student resists the suggestion of medical leave and wants instead to remain on campus, the suggestion of medical leave may turn into a demand.

According to interim Dean of Student Affairs Terry Martinez, instances of involuntary leave—in which a student is essentially forced to leave—happen about once a year at most. "When we take a look at involuntary medical leave, it is because we believe from information from faculty, RA, advisors, that there is a serious concern about an individual, and we believe they might pose a danger to themselves or the community," Martinez explains.

The Wellness Divide

Many students tend to be wary of the University's justification for demanding leave, often citing liability as its primary motivation. For example, Agrawal notes that Barnard or Columbia can demand students battling mental illness to take leave, due to a policy that says no student is allowed to threaten any member of the community. "If you are considering suicide or make an attempt, then you are violating a member of the community—yourself," Agrawal says. Violation of this rule gives the college leverage to forcibly ask a student to take leave, even if the student does not want to.

Likewise, if a student is experiencing suicidal thoughts and CPS advises the student to check into a hospital, the University is then made aware of their psychological state. This can factor into the University's decision of whether or not to ask that a student take medical leave. While some say this is a way to ensure the student receives treatment, the fear of a visit to CPS ending with a suggestion to take medical leave—with no alternative—might deter students from getting attention in the first place.

In defense of suggesting that students take leave involuntary leave, Martinez explains, "It is our obligation to make sure students are safe and functioning, and that the community is safe and functioning."

"If students are not pleased with the outcome, I get it," Martinez says. "They want to be here. They want to stay connected with their friends. But if all the evidence we have in front of us [suggests] they are a threat to the environment, but every weekend they take pills and threaten suicide, and their friends are constantly responding—that has a tremendous effect on the community." In that sense, suggesting, and perhaps demanding, that a student take leave is as much about protecting the Columbia community as it is about protecting the student.

The question remains how and when student activists will formally address forced medical leave procedures at Columbia and Barnard. Regardless, the battle will not be a clear-cut case of good students against an evil administration. Martinez says she treats students undergoing leave procedures with genuine compassion. "None of these instances are easy," she says. "Every single one has a different tenor and is extremely emotional."

In many cases, students are initially hurt by their ultimatum, Martinez says. "Their interpretation can be very different from ours. They're embarrassed, they want to feel protected, and they don't want people to know." Yet, these same students are often grateful for the year they spend away from Columbia when all is said and done.

The fact that forced leave is such a source of discontent on campus perhaps indicates a problem much deeper than the policies themselves: If we can't agree on when someone needs to take leave, perhaps we don't agree on what it even means to take leave. Is it surrendering, or is it turning your life around? Simply put by the student who struggled with an eating disorder, "I don't know what would have happened if I hadn't taken time off."

When You Can't Afford It

Some students feel they are unable to take leave, even if they think it would be healthy for them.

Currently, there are no official financial support systems in place to help students with specific costs associated with taking a leave—like transportation, cost of therapy, or lost income associated with giving up a campus job. These costs can add up, making leaves financially burdensome for some students. Loss of guaranteed housing upon returning from a voluntary leave (for the purposes of pursuing something outside of college—like an internship, start-up, or travels, that does not have to do with a medical or family emergency), can be a financial hardship too extreme for a low-income student to risk.

Martinez suggests that these financial hardships can be addressed if students are active about voicing their concerns. "When students approach us for support, we try and make sure to support them," she says.

For example, if transportation costs for a CPS readmittance interview are financially burdensome, the first step is for the student to communicate this concern with their advisor. From there, they can work together to find potential avenues for financial support—but it is up to the student to ask for help. With regards to receiving medical care away from campus, Martinez also notes that CPS will help students locate treatment centers near their location of residence during their leave, and will look for specific centers that offer help on a sliding scale or for free, if need be. Wary of generalizations, Martinez will not readily admit that taking a leave of absence is always financially harder than staying at Columbia.

Still, in some cases financial situations and an emotional commitment to sticking out college can encourage students to forgo even medical leave or family emergency leave. Brittany Carroll-Watts, a Columbia College senior, has endured a broken ankle, a diagnosis of low-grade depression, and family deaths throughout her seven semesters thus far. Though she has considered taking leave to heal from her problems away from an academic environment that exhausted her, she felt that the stress involved with leaving Columbia would outweigh the potential benefits. Carroll-Watts believed a leave of absence would require complicated financial aid reassessments, and would necessitate that she move in with her mom, which would not be an ideal situation for her. She would not have the funds to live or travel elsewhere.

Although at times she wanted and felt she might have benefited from a break, she also felt a driving force to stick out her four years—in other words, a pressure to stay "on track." "It's not presented to us as an option to take time off while you are in school. You are enrolled, you do four years," she says.

To some, a break suggests a loss of ambition, and can scare the loved ones of those who need to take time away from the structured school-work-school dynamic. The adults in Carroll-Watts' life get nervous at the thought of her taking a break, fearing that she may not jump back on track. Though she has decided that after college she will work at an undecided job for two years in Seattle while creating an album of music instead of immediately pursuing her law degree, she is aware of others' fear that she will never reach her full potential as a Columbia graduate if she takes this two-year unstructured break. What if she never goes on to get her law degree?

It's that cultural myth again: Breaks are bad. That conviction, combined with financial complications, can be enough to prevent a struggling student from taking the break they need.

The Politics and Problems of Return

Of course, not all the disadvantages associated with taking leaves of absence are necessarily myths. When it comes to returning from a break, the social repercussions can also be exhausting.

When students return, their friends have grown together without them. Even if students grow as much or even more than their peers during their leaves, they don't grow along with the people they started college with. That isolation upon return isn't a part of the myth that one shouldn't take a break—but instead, a real, difficult aspect involved with coming back.

Peter Cohen, who returned after a year of academic suspension following his freshman year, faced this kind of difficulty in returning to campus. Like Hisel, his academic record took a dive that correlated with his depression, and he stopped going to class.

"I guess I'd say I didn't realize it was a depression at the time," says Cohen, who would sometimes ride the 1 train all the way to South Ferry and back, just to feel like he had done something with his day. He failed or received an unofficial withdrawal from all of his classes, except for Italian (B+) his first semester of college. He was put on academic probation, and not much else changed his second semester, except he failed or received an unofficial withdrawal from all of his classes. When Cohen learned of his academic suspension following his second semester, he says it felt like a "colossal failure," although the decision was not unexpected. As part of his suspension terms, he had to complete 15 to 18 credits at a four-year accredited university, so he enrolled at California State Long Beach while living at home near Los Angeles. There, he received straight As while getting support from a psychiatrist. Having satisfied his credit requirements during academic suspension, Cohen returned to Columbia fall semester only to face a new problem that prompted him to take another leave of absence in the spring.

"At the beginning of the semester, I certainly felt a strong sense of motivation, drive, and determination to do better than I had. To a large extent, I was succeeding in the first six weeks, but then the motivation went away," he remarks. In its place came an unavoidable feeling of social isolation, which brought back his depression. Reintegration was so rocky that once he was home for winter break, he made the decision to take another leave, despite having received As and Bs that semester. An academic problem had morphed into a social one. College can be a lonely place after a break.

Despite his struggles, Cohen ultimately looks back on his experience positively. "In a weird sense, I feel grateful that this has happened to me," he says. "I feel like it's been humbling. I think, what if this didn't happen to me now? What if this happened when I'm 44 and have several kids?" His leave of absence was a growing experience—a lesson that health and happiness are more important than doing well in school.

The Beauty of Going off The Tracks

Columbia College junior Jacob Jirak also took a leave. His was voluntary and bore hefty costs—namely, a loss of guaranteed housing and being considered "crazy" by his family for his plans while on leave. Feeling disillusioned with Columbia, Jirak felt he needed a break from his student life. Unsure of what to do with his time but recognizing a strong desire to travel, he embarked on a two-month journey on foot: from Virginia Beach to Apalachicola, Fla.

It wasn't an experience he could even fathom at Columbia, nor was the vision that came to him while he was walking up a hill in the middle of Georgia. "I had one of those weird moments, it's true," he says. "It was an intensely personal experience. I felt like I was standing on the tallest mountain in the world, and I could see everything. It's like the past 20 years of my life made sense."

Perhaps that is a moment that most people spend their lives searching for—and for Jirak, it took a break from the standard Columbia existence to experience it. Some time after his moment in Georgia, he realized that writing is what he wants to do with his life. "Of course that means poverty and isolation," he acknowledges somewhat lightheartedly.

Jirak decided to return after one semester of leave, but missed the deadline to reapply. After sending his advisor a desperate email, he was told he could re-enter. "In some ways bureaucracy is not as labyrinthine as we [believe] it to be," he remarks.

Not everyone who takes a leave of absence will experience what Jirak did, and in fact, some might even experience similar revelations during their time at Columbia. But for him, at least, the time off was essential for his personal growth.

In fact, this may be true of many Columbians, whether we admit it or not. Many feel that by the time we graduate we will have learned how to go to school and little else. The bigger questions—like who we are aside from students—may be best answered with a little distance from a highly academic environment, whether necessitated by health or a strong case of wanderlust. Wouldn't it be better to experience that distance while we're still young, and our true adulthood has yet to begin?

"Taking time off"—it means something different to everyone. We're quick to judge Hisel, Cohen, and Jirak for their time away—for having to leave. All the more credit to them for doing so—and for finding recovery, revelation, and pain along the way. Despite the student groups working to make the leave process easier, without administrative help, progress will be difficult.

We are more than students, and sometimes it takes a break from the University to figure out what that means.

Correction: This article originally said that Peter Cohen received a D+ in Italian. He actually received a B+. In addition, identifying information about a source has been removed because of a misunderstanding about what level of confidentiality the source requested. The Eye regrets the errors. 

leaves of absence psychological cps mental health eating disorders Terry Martinez time out Dean of Student Affairs